Exploring knowledge and implementation gaps of activity-based therapy in centers lacking specialized spinal cord injury services: understanding therapists' perspectives

Study design: Qualitative exploratory. Objectives: To explore the existing knowledge, perceptions, and implementation of activity-based therapy (ABT) among physical and occupational therapists working in centers lacking spinal cord injury (SCI)-specific services (non-SCI-specialized centers). Setting: Canadian hospitals and community clinics. Design/Methods: Semi-structured interviews were conducted with Canadian therapists who worked at non-SCI-specialized centers and had treated at least one person with SCI in the last 18 months. Interview questions, informed by the Theoretical Domains Framework, probed therapists’ experiences with SCI rehabilitation and ABT. Interviews were audio-recorded, transcribed verbatim, and analyzed using interpretive description. Results: Seven participants (4 physical therapists, 3 occupational therapists) from diverse settings (acute care, inpatient rehabilitation, long-term care, outpatient rehabilitation, rural outpatient clinic) participated. Three themes emerged: (1) Available knowledge, resources, and therapy time in non-SCI-specialized centers challenge ABT implementation; (2) Current therapy practices in non-SCI-specialized centers partially align with ABT, often unconsciously; and (3) Desire for ABT knowledge. Although participants were generally unfamiliar with the term ABT, many realized they were incorporating components of ABT into practice. Participants expressed strong interest in learning more about ABT. Conclusion: Knowledge and implementation of ABT in non-SCI-specialized centers are limited. Tailored ABT education for therapists in these settings may increase ABT implementation.